Legislature(2011 - 2012)BUTROVICH 205

01/30/2012 01:30 PM HEALTH & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ SB 172 CARE DIRECTIVES/DO NOT RESUSCITATE ORDERS TELECONFERENCED
Moved SB 172 Out of Committee
*+ SB 144 STATE IMMUNIZATION PROGRAM TELECONFERENCED
Heard & Held
Bills Previously Heard/Scheduled
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                        January 30, 2012                                                                                        
                           1:31 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Bettye Davis, Chair                                                                                                     
Senator Dennis Egan                                                                                                             
Senator Kevin Meyer                                                                                                             
Senator Fred Dyson                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Johnny Ellis                                                                                                            
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 172                                                                                                             
"An Act relating to health care decisions, including do not                                                                     
resuscitate orders."                                                                                                            
                                                                                                                                
     - MOVED SB 172 OUT OF COMMITTEE                                                                                            
                                                                                                                                
SENATE BILL NO. 144                                                                                                             
"An Act temporarily reinstating the child and adult immunization                                                                
program in the Department of Health and Social Services; and                                                                    
providing for an effective date."                                                                                               
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB 172                                                                                                                  
SHORT TITLE: CARE DIRECTIVES/DO NOT RESUSCITATE ORDERS                                                                          
SPONSOR(s): SENATOR(s) DYSON                                                                                                    
                                                                                                                                
01/20/12       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/20/12       (S)       HSS, JUD                                                                                               
01/30/12       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB 144                                                                                                                  
SHORT TITLE: STATE IMMUNIZATION PROGRAM                                                                                         
SPONSOR(s): SENATOR(s) GIESSEL, OLSON                                                                                           
                                                                                                                                
01/17/12       (S)       PREFILE RELEASED 1/6/12                                                                                
01/17/12       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/17/12       (S)       HSS, FIN                                                                                               
01/30/12       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
SENATOR FRED DYSON                                                                                                              
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Sponsor of SB 172.                                                                                        
                                                                                                                                
CHUCK KOPP, Staff                                                                                                               
Senator Fred Dyson                                                                                                              
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Presented the sectional analysis of SB 172                                                                
on behalf of the sponsor.                                                                                                       
                                                                                                                                
TERRY BANNISTER, Attorney                                                                                                       
Legislative Legal and Research Services                                                                                         
Legislative Affairs Agency                                                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions related to SB 172.                                                                     
                                                                                                                                
WARD HURLBURT, M.D.                                                                                                             
Director and Chief Medical Officer                                                                                              
Division of Public Health                                                                                                       
Department of Health and Social Services (DHSS)                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified on SB 172 and on SB 144.                                                                        
                                                                                                                                
SENATOR CATHY GIESSEL                                                                                                           
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Co-sponsor of SB 144.                                                                                     
                                                                                                                                
JONATHAN TAYLOR, Intern                                                                                                         
Senator Cathy Giessel                                                                                                           
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Presented the sectional analysis of SB 144                                                                
for the sponsor.                                                                                                                
                                                                                                                                
ROSALYN SINGLETON, M.D.                                                                                                         
American Academy of Pediatrics                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 144.                                                                           
                                                                                                                                
GEORGE RHYNEER, M.D.                                                                                                            
Legislative Affairs Chair                                                                                                       
Alaska Physicians and Surgeons                                                                                                  
Eagle River, Alaska                                                                                                             
POSITION STATEMENT: Testified in support of SB 144.                                                                           
                                                                                                                                
RANDI SWEET                                                                                                                     
United Way of Anchorage                                                                                                         
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 144.                                                                           
                                                                                                                                
MARY SULLIVAN                                                                                                                   
Alaska Primary Care Association                                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Testified in support of SB 144.                                                                           
                                                                                                                                
CHUCK WHEELER                                                                                                                   
Nome, Alaska                                                                                                                    
POSITION STATEMENT: Testified in support of SB 144.                                                                           
                                                                                                                                
GEORGE BROWN, M.D.                                                                                                              
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Testified in support of SB 144.                                                                           
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:31:37 PM                                                                                                                    
CHAIR BETTYE DAVIS  called the Senate Health  and Social Services                                                             
Standing Committee meeting  to order at 1:31 p.m.  Present at the                                                               
call to order were Senators Egan, Dyson, Meyer, and Chair Davis.                                                                
                                                                                                                                
        SB 172-CARE DIRECTIVES/DO NOT RESUSCITATE ORDERS                                                                    
                                                                                                                                
1:32:43 PM                                                                                                                    
CHAIR DAVIS  announced that the  first order of business  to come                                                               
before the committee was SB 172, of which she is a co-sponsor.                                                                  
                                                                                                                                
SENATOR FRED DYSON,  primary sponsor, stated that  the purpose of                                                               
SB  172  is  to  correct   possible  ambiguities  in  end-of-life                                                               
decisions currently in statute and  ensure that the intent of the                                                               
legislature is followed. It also  protects patient rights and do-                                                               
not-resuscitate (DNR)  orders. He  emphasized that  the patient's                                                               
wishes should always  predominate. In the case  of an incompetent                                                               
patient,  the  responsibility would  fall  to  family members  or                                                               
authorized surrogates.                                                                                                          
                                                                                                                                
SENATOR DYSON related  that the Health Care  Decisions Act, which                                                               
was  passed  in  2004,  changed provisions  in  AS  13.52.120  by                                                               
establishing  a presumption  in favor  of life.  When there  is a                                                               
question as to what should  be done medically, the presumption is                                                               
to preserve  the life of  the patient.  He said he  believed that                                                               
when the  statute is read in  its entirety, it can  and should be                                                               
interpreted   to  allow   the   patient,   or  their   authorized                                                               
representative, to prevent a physician  from issuing a DNR order.                                                               
This  legislation would  clarify the  authority of  DNR decisions                                                               
with respect to the patient  and physicians, and amend the Alaska                                                               
Care Directive form  to allow patients to accept  or refuse life-                                                               
sustaining procedures.  He reported no  opposition to SB  172 and                                                               
noted  that it  has also  been referred  to the  Senate Judiciary                                                               
Standing Committee.                                                                                                             
                                                                                                                                
1:35:56 PM                                                                                                                    
CHUCK  KOPP,  staff to  Senator  Dyson,  presented the  sectional                                                               
analysis:                                                                                                                       
                                                                                                                                
     Section  1 amends  AS 13.52.045  to  prohibit a  health                                                                    
     care  institution  or  facility from  interpreting  the                                                                    
     issuance of a DNR order  as preventing the providing of                                                                    
     life-sustaining procedures to the patient.                                                                                 
                                                                                                                                
     Section 2  amends AS 13.52.060(e) to  prohibit a health                                                                    
     care   provider   from   declining,  for   reasons   of                                                                    
     conscience,  to  comply  with   a  DNR  order  that  is                                                                    
     consistent with  this chapter. It also  states that the                                                                    
     subsection  does  not  allow a  health  care  provider,                                                                    
     institution, or  facility to decline to  comply with an                                                                    
     individual instruction  or a health care  decision that                                                                    
     requests  that cardiopulmonary  resuscitation (CPR)  or                                                                    
     other resuscitative measures be provided.                                                                                  
                                                                                                                                
     Section  3 amends  AS 13.52.060(f)  to  state that  the                                                                    
     subsection  does  not  allow a  health  care  provider,                                                                    
     institution, or  facility to decline to  comply with an                                                                    
     advance  health   care  directive  or  a   health  care                                                                    
     decision that  is consistent with the  chapter and that                                                                    
     requests that  CPR or  other resuscitative  measures be                                                                    
     provided. The subsection  addresses declining to comply                                                                    
     with an individual instruction  or health care decision                                                                    
     that  requires  medically  ineffective health  care  or                                                                    
     health care contrary to  generally accepted health care                                                                    
     standards.                                                                                                                 
                                                                                                                                
MR. KOPP noted a drafting error  on page 2, line 13; "declined to                                                               
comply with an advanced health  care directive" should be changed                                                               
to "declined  to comply with  an individual instruction"  to make                                                               
it consistent with line 9.                                                                                                      
                                                                                                                                
CHAIR DAVIS commented that Terry Bannister was available to                                                                     
answer questions.                                                                                                               
                                                                                                                                
MR. KOPP continued:                                                                                                             
                                                                                                                                
     Section   4  amends   AS   13.52.065(a)   to  limit   a                                                                    
     physician's  right  to  issue   a  DNR  order  only  as                                                                    
     provided in AS 13.52.065.                                                                                                  
                                                                                                                                
     Section 5  amends AS 13.52.065(b)  to require  that the                                                                    
     protocol adopted by the  department for withholding CPR                                                                    
     comply with AS 13.52.065.                                                                                                  
                                                                                                                                
     Section 6  adds new  subsections (g-j).  Subsection (g)                                                                    
     prohibits a  physician from issuing  a DNR order  for a                                                                    
     patient without  the express  consent described  in the                                                                    
     subsection, except  as provided in (h).  Subsection (h)                                                                    
     states that  a physician  may issue a  DNR order  for a                                                                    
     patient without  the expressed consent required  by (g)                                                                    
     if  the  patient does  not  have  capacity, no  one  is                                                                    
     authorized  to  make  health care  decisions,  and  the                                                                    
     patient  has an  advanced  health  care directive  that                                                                    
     indicates  the  patient  wants  a  DNR  order,  or  the                                                                    
     directive is silent  about the issuance of  a DNR order                                                                    
     and another physician concurs in the decision.                                                                             
                                                                                                                                
     Subsection  (i) requires  a physician  to revoke  a DNR                                                                    
     order  for  a  patient  if  the  issuance  of  the  DNR                                                                    
     violates (g), if the patient  has capacity and requests                                                                    
     that the DNR order be  revoked, if the patient does not                                                                    
     want  a DNR  order, or  if  the patient  does not  have                                                                    
     capacity  and  does not  have  an  advance health  care                                                                    
     directive that indicates that the  patient wants a DNR,                                                                    
     and a  person authorized to make  health care decisions                                                                    
     for  the  patient  requests  or  does  not  oppose  the                                                                    
     revocation  of the  DNR order.  A physician  shall also                                                                    
     revoke a DNR order if the  patient is under 18 years of                                                                    
     age and the parent or  guardian of the patient requests                                                                    
     that the DNR order be revoked.                                                                                             
                                                                                                                                
     Subsection (j) says a physician  may revoke a DNR order                                                                    
     issued  by  another  physician for  a  patient  if  the                                                                    
     physician  has a  physician-patient  relationship or  a                                                                    
     health care obligation to the patient.                                                                                     
                                                                                                                                
     Section  7,   amends  AS  13.52.080(a)  to   replace  a                                                                    
     citation  to  a subsection  that  is  repealed by  this                                                                    
     bill.                                                                                                                      
                                                                                                                                
     Section 8  amends AS 13.52.080(c)  to provide  that its                                                                    
     immunity provisions do not apply  if a DNR order relied                                                                    
     on  by  the  health   care  provider,  institution,  or                                                                    
     facility was issued in violation of AS 13.52.065.                                                                          
                                                                                                                                
     Section  9 amends  AS 13.52.120(b)  to  clarify that  a                                                                    
     violation of  the new provisions added  by bill section                                                                    
     6, does not, in the  context of the provisions required                                                                    
     consistency  with the  chapter, constitute  a homicide.                                                                    
     It also  adds a cross  reference to  the new (h)  as an                                                                    
     exception  for applying  the  subsection's approach  to                                                                    
     suicide or homicide.                                                                                                       
                                                                                                                                
     Section  10  adds AS  13.52.120(h)  to  state that  the                                                                    
     provisions  in (b)  about homicide  and suicide  do not                                                                    
     apply to a person who  orders or causes the withholding                                                                    
     or  withdrawal of  life-sustaining procedures  and acts                                                                    
     intentionally,  recklessly,  with criminal  negligence,                                                                    
     or with gross negligence.                                                                                                  
                                                                                                                                
     Section 11 amends the optional  form in AS 13.52.300 to                                                                    
     add  a section  regarding a  patient's wishes  on life-                                                                    
     sustaining  procedures. He  directed attention  to page                                                                    
     13 of the bill.                                                                                                            
                                                                                                                                
     Section   12  Amends   AS  13.52.390,   the  definition                                                                    
     section,  to  change  the definition  of  "health  care                                                                    
     decision" to  state that the term  includes a direction                                                                    
     about receiving CPR or other resuscitative measures.                                                                       
                                                                                                                                
     Section  13 repeals  AS  13.52.065(f), which  currently                                                                    
     addresses how DNR orders are made ineffective.                                                                             
                                                                                                                                
     Section 14 adds a provision  to indicate how DNR orders                                                                    
     made  before  the  bill's  effective  date  are  to  be                                                                    
     treated in light of the bill.                                                                                              
                                                                                                                                
TERRY BANNISTER, Attorney, Legislative Legal and Research                                                                       
Services, Legislative Affairs Agency, agreed that the previously                                                                
suggested correction would parallel previous language.                                                                          
                                                                                                                                
1:47:49 PM                                                                                                                    
WARD  HURLBURT,   M.D.,  Director  and  Chief   Medical  Officer,                                                               
Division  of  Public  Health, Department  of  Health  and  Social                                                               
Services (DHSS), stated  that SB 172 matched his  experience as a                                                               
doctor and hospital  administrator. He agreed with  the intent of                                                               
the bill to  honor the patient's wishes and to  prolong life when                                                               
there  is a  question  about what  is to  be  done medically.  He                                                               
called the  bill reasonable and  appropriate. He stated  that the                                                               
bill would not require additional funding.                                                                                      
                                                                                                                                
CHAIR DAVIS  thanked the sponsor  for addressing health  care DNR                                                               
decisions.  She  said the  bill  has  been  sent to  the  Medical                                                               
Association  and  has  been  referred  to  the  Senate  Judiciary                                                               
Standing Committee.                                                                                                             
                                                                                                                                
SENATOR   DYSON  commented   that   the  bill   was  written   in                                                               
collaboration  with  one  of  the   major  health  providers.  He                                                               
preferred to move the bill.                                                                                                     
                                                                                                                                
CHAIR DAVIS said she had no problem moving the bill.                                                                            
                                                                                                                                
1:51:48 PM                                                                                                                    
SENATOR  EGAN  moved  to  report   SB  172  from  committee  with                                                               
individual recommendations and attached zero fiscal note.                                                                       
                                                                                                                                
CHAIR DAVIS announced  that without objection, SB  172 moved from                                                               
the Senate Health and Social Services Committee.                                                                                
                                                                                                                                
               SB 144-STATE IMMUNIZATION PROGRAM                                                                            
                                                                                                                                
1:52:36 PM                                                                                                                    
CHAIR DAVIS announced the consideration of SB 144.                                                                              
                                                                                                                                
SENATOR  CATHY  GIESSEL,  co-sponsor,   introduced  SB  144.  She                                                               
recalled  the  history  of smallpox  inoculation  in  the  United                                                               
States  initiated by  George Washington.  She said  that smallpox                                                               
has been essentially wiped out  due to effective vaccination. She                                                               
shared  the history  of  the Iditarod  Sled  Dog Race,  initially                                                               
called the  Great Race of Mercy,  due to its role  in saving Nome                                                               
from being decimated  by diphtheria, which, today,  has also been                                                               
eradicated  due to  vaccination. Polio  has also  been eradicated                                                               
because of vaccination programs.                                                                                                
                                                                                                                                
She  spoke  of  generous  funding for  Alaska  from  Senator  Ted                                                               
Steven's  office,   which  provided  a   "universal"  vaccination                                                               
program.  In 2008  the Center  for Disease  Control began  to cut                                                               
back federal  funding for the  Alaska Immunization  Program (AIP)                                                               
from  $4.3 million  to $700,000  for FY13.  Due to  this loss  of                                                               
funding, the  state has discontinued vaccinations  for adults and                                                               
for  around 47,000  underinsured children.  SB 144  would provide                                                               
state-funded vaccinations until 2015.                                                                                           
                                                                                                                                
1:58:16 PM                                                                                                                    
JONATHAN  TAYLOR,  intern  to   Senator  Giessel,  presented  the                                                               
sectional  analysis  for the  sponsor.  He  said that  Section  1                                                               
provides  a statement  of legislative  intent pertaining  to AIP,                                                               
which is  established in  Section 2  of the  bill. It  includes a                                                               
summary of the past and future  of the program and emphasizes the                                                               
temporary nature of the program.                                                                                                
                                                                                                                                
Section 2 establishes AIP in  the Department of Health and Social                                                               
Services  (DHSS)   and  requires  the  department   to  determine                                                               
eligibility, moved to adopt regulations,  and apply for available                                                               
funds.  It  establishes  standards  for  provider  and  recipient                                                               
participation  in  the  program  and the  types  of  vaccinations                                                               
covered.                                                                                                                        
                                                                                                                                
Section  3 authorizes  the immediate  adoption of  regulations by                                                               
DHSS.                                                                                                                           
                                                                                                                                
Section 4  establishes a delayed  repeal of  the Act of  June 30,                                                               
2015.                                                                                                                           
                                                                                                                                
Section 5 provides an immediate effective date.                                                                                 
                                                                                                                                
1:59:43 PM                                                                                                                    
SENATOR GIESSEL introduced Rosalyn Singleton and George Rhyneer.                                                                
                                                                                                                                
2:00:31 PM                                                                                                                    
ROSALYN   SINGLETON,  M.D.,   American  Academy   of  Pediatrics,                                                               
testified in support of SB 144.  She recalled her experience as a                                                               
pediatrician before vaccinations were  available. She shared what                                                               
would happen  if vaccinations  were not  reinstated. If  the bill                                                               
does not  pass, next year  the state would provide  vaccines only                                                               
for children  who are eligible  under Medicaid and  Alaska Native                                                               
programs  or who  are uninsured.  This  puts Alaska  at risk  for                                                               
outbreaks of measles and other infections.                                                                                      
                                                                                                                                
2:03:13 PM                                                                                                                    
GEORGE   RHYNEER,  M.D.,   Legislative   Affairs  Chair,   Alaska                                                               
Physicians  and Surgeons,  testified  in support  of  SB 144.  He                                                               
spoke  of  the  benefits  he  and his  family  and  friends  have                                                               
received from the state vaccination  program. He said a letter of                                                               
support would be forthcoming.                                                                                                   
                                                                                                                                
2:04:21 PM                                                                                                                    
RANDI SWEET, United Way of  Anchorage, testified in support of SB                                                               
144. She encouraged a long-term  funding resolution for the state                                                               
vaccination program.  She described  vaccinations as  critical to                                                               
both  adults'   and  children's  health.  She   referred  to  the                                                               
constitutional  mandate  that  the legislature  provide  for  the                                                               
promotion and  protection of  public health,  which SB  144 would                                                               
do.                                                                                                                             
                                                                                                                                
2:05:52 PM                                                                                                                    
MARY  SULLIVAN, Alaska  Primary  Care  Association, testified  in                                                               
support  of  SB  144.  She  spoke  of  the  negative  effects  on                                                               
community health centers if vaccinations are not increased.                                                                     
                                                                                                                                
2:07:40 PM                                                                                                                    
WARD  HURLBURT,   M.D.,  Director  and  Chief   Medical  Officer,                                                               
Division  of  Public  Health, Department  of  Health  and  Social                                                               
Services (DHSS), testified  on SB 144.  He said  DHSS is in favor                                                               
of the bill, but requires a  minimal fiscal note. He spoke of his                                                               
experience  in Dillingham  when  there were  no vaccinations.  He                                                               
shared that Alaska  currently rates at number 42  among states in                                                               
immunization  programs. Half  of the  children in  Alaska qualify                                                               
for federally funded vaccination  programs. About 25 percent have                                                               
coverage  through  private insurance.  The  bill  targets the  25                                                               
percent  that do  not qualify  for  federal funding  and have  no                                                               
insurance.                                                                                                                      
                                                                                                                                
DR.  HURLBURT  related  that from  a  public  health  standpoint,                                                               
without an  immunization rate  of 80 percent,  there is  no "herd                                                               
immunity", which means  there is a risk to  the whole population.                                                               
Alaska has  the highest percentage  of "parental hesitancy"  at 9                                                               
percent. The department is working  on that issue. He gave credit                                                               
to  the   health  care  workers   in  Talkeetna,   a  challenging                                                               
community, for their efforts to increase the immunization rate.                                                                 
                                                                                                                                
CHAIR DAVIS  commented that  a fiscal  note was  forthcoming from                                                               
DHSS.                                                                                                                           
                                                                                                                                
2:11:56 PM                                                                                                                    
CHUCK  WHEELER, Nome,  testifying  on his  own  behalf, spoke  in                                                               
support of SB 144. He said the  state was notified in 2008 of the                                                               
funding cuts and last year he  was aware of federal funding cuts.                                                               
He noted that immunization costs  keep escalating and the funding                                                               
keeps decreasing. He  shared statistics of high  disease rates in                                                               
Northwest  Alaska. Vaccinations  are not  available in  Nome. The                                                               
uninsured cannot  afford vaccinations. He  supported vaccinations                                                               
as a needed prevention program.                                                                                                 
                                                                                                                                
2:15:18 PM                                                                                                                    
GEORGE BROWN, M.D.,  testified in support of SB  144. He inquired                                                               
about medical costs  per child of the whooping  cough vaccine, as                                                               
opposed  to  the  cost  of  the outbreak  of  whooping  cough  in                                                               
Southeast  Alaska in  2007-8.  He said  the  vaccine costs  about                                                               
$2.40.  He   asked  about   the  cost   of  the   H1N1  influenza                                                               
vaccination, versus the cost of  the epidemic in 2009-10. He said                                                               
the cost  of the vaccine  was about  $3.20. He reported  that the                                                               
cost savings for the measles,  mumps, and rubella vaccination was                                                               
$16  for  every   dollar  invested.  He  noted   that  the  child                                                               
vaccination program in Washington State  consists of a pooling of                                                               
federal, private,  and state  funds to  assure that  all children                                                               
receive all recommended immunizations.                                                                                          
                                                                                                                                
2:18:20 PM                                                                                                                    
CHAIR  DAVIS  said  she  was  familiar  with  Washington  State's                                                               
program  and  suggested  pooling  might   be  a  good  method  of                                                               
providing an immunization  program for Alaska. She  said the task                                                               
at  hand  is  to  fund   Alaska's  program  for  this  year.  She                                                               
emphasized that SB 144 was a very important bill.                                                                               
                                                                                                                                
SENATOR EGAN  referred to  page 3,  subsection (f)(1),  and asked                                                               
why   meningococcal  and   human  papillomavirus   vaccines  were                                                               
exempted.                                                                                                                       
                                                                                                                                
DR. HURLBURT  responded that the  two vaccines were  not included                                                               
because they  are very costly and  the cost benefit ratio  is not                                                               
as good.  For most other  vaccines, the savings in  medical costs                                                               
is about  $8 per child  for every dollar  spent. The goal  of the                                                               
legislation is  to make  the program  affordable and  provide the                                                               
best protection, first for the  children, and then for adults who                                                               
don't have other coverage.                                                                                                      
                                                                                                                                
SENATOR EGAN wondered  why this issue couldn't  be addressed long                                                               
term, rather than temporarily.                                                                                                  
                                                                                                                                
SENATOR  GIESSEL  stated  that  the reason  the  bill  only  goes                                                               
through  2015 is  because the  plan  is to  research other  state                                                               
immunization  programs  in order  to  come  up with  a  long-term                                                               
program for Alaska.                                                                                                             
                                                                                                                                
DR.  HURLBURT  spoke  of  models  found  in  Washington  and  New                                                               
Hampshire. There  are cost and  supply advantages for a  state to                                                               
purchase  all  immunizations  in  order  to  create  a  universal                                                               
program. Alaska is attempting to have a universal program.                                                                      
                                                                                                                                
2:23:55 PM                                                                                                                    
SENATOR  DYSON  said   he  thought  the  bill   could  move  from                                                               
committee.                                                                                                                      
                                                                                                                                
SENATOR DAVIS said she would prefer  to have a fiscal note first.                                                               
She added that  another issue which merits attention  is the "opt                                                               
out" choice parents have.                                                                                                       
                                                                                                                                
SENATOR MEYER questioned how to  address the 9 percent of parents                                                               
who are reluctant to have their children immunized.                                                                             
                                                                                                                                
DR.  HURLBURT  said he  thought  education  was the  solution  to                                                               
dispelling false information about  immunizations. He referred to                                                               
a British study which promoted  a misconception that vaccinations                                                               
caused autism. There is also  the issue that a two-year-old needs                                                               
about  15  shots  over  the first  couple  years,  which  bothers                                                               
parents. Cost is also a  concern. Public health nurses and school                                                               
requirements  are part  of the  solution. Mississippi  has a  law                                                               
that requires a provider's note  to excuse a child from receiving                                                               
vaccinations.                                                                                                                   
                                                                                                                                
SENATOR MEYER asked  what the average rate  of parental hesitancy                                                               
was.                                                                                                                            
                                                                                                                                
DR. HURLBURT  explained that 9  percent is the number  of parents                                                               
who  opt  out  of  having   their  children  immunized.  Alaska's                                                               
immunization  rate   is  currently  60  percent.   Alaska  Native                                                               
children have an immunization rate of 90 percent.                                                                               
                                                                                                                                
CHAIR DAVIS held SB 144 in committee.                                                                                           
                                                                                                                                
2:30:18 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair  Davis  adjourned the  Senate  Health  and Social  Services                                                               
Standing Committee meeting at 2:30 p.m.                                                                                         
                                                                                                                                

Document Name Date/Time Subjects
SB172 Bill.pdf SHSS 1/30/2012 1:30:00 PM
SB 172
SB172 Sponsor Statement.pdf SHSS 1/30/2012 1:30:00 PM
SB 172
SB172 Legal Memo 1.jpg SHSS 1/30/2012 1:30:00 PM
SB 172
SB172 Legal Memo 2.jpg SHSS 1/30/2012 1:30:00 PM
SB 172
SB172 Legal Memo 3.jpg SHSS 1/30/2012 1:30:00 PM
SB 172
SB172 Legal Memo 4.jpg SHSS 1/30/2012 1:30:00 PM
SB 172
SB172 Legislative Research Memo 1.pdf SHSS 1/30/2012 1:30:00 PM
SB 172
SB172 Ltr to Senator Davis from Sen. Dyson.pdf SHSS 1/30/2012 1:30:00 PM
SB 172
SB144 Bill.pdf SHSS 1/30/2012 1:30:00 PM
SB 144
SB 144 Sponsor Statement.pdf SHSS 1/30/2012 1:30:00 PM
SB 144
SB 144 Sectional Analysis.pdf SHSS 1/30/2012 1:30:00 PM
SB 144
SB 144 Proposed Participants.pdf SHSS 1/30/2012 1:30:00 PM
SB 144
SB 144 Epidemiology Bulletin 2 1062010.pdf SHSS 1/30/2012 1:30:00 PM
SB 144
SB 144 Epidemiology Bulletin 1 10192011.pdf SHSS 1/30/2012 1:30:00 PM
SB 144